Oral Contraceptives OTC Access

ACOG recommends that oral contraceptives be made available over the counter. Vice President of Practice Activities, Gerald F. Joseph, Jr., MD, outlines the recommendation in this video.

Committee Opinion #554 “Over-the-Counter Access to Oral Contraceptives”, found in the December 2012 issue of Obstetrics & Gynecology, calls for making oral contraceptives (OCs) available over-the-counter as a means of curbing the Nation’s high unintended pregnancy rate. Already, new private health plans must cover without cost sharing all FDA-approved contraceptive methods as part of the Affordable Care Act’s preventive services package.

ACOG’s recommendation emphasizes the importance of an annual health assessment for every woman as a fundamental part of medical care, including cervical cancer screening and sexually transmitted infection screening, but notes that cervical cancer and STI screening “is not required for initiating OC use and should not be used as barriers to access.”

ACOG’s recommendations include:

Oral contraceptives (OCs) should be sold over the counter (OTC) in drugstores without a doctor’s prescription. Easier access to OCs should help lower the nation’s high unintended pregnancy rate, a rate that has not changed over the past 20 years and costs taxpayers an estimated $11.1 billion annually.

Cost, access, and convenience issues are common reasons why women do not use contraception or use it inconsistently. There are no OCs currently approved for OTC access; OTC availability will improve women’s access to and use of contraception. The benefits of making OCs easily accessible outweigh the risks.

Even though no drug is risk-free, the overall consensus is that OCs are safe. There is a risk of blood clots with OC use, but it is extremely low and significantly lower than the risk of blood clots during pregnancy and the postpartum period. Aspirin and acetaminophen are both available OTC even though they have well-known health risks.

Studies show women support OTC access to OCs and are able to self-screen with checklists to determine their health risks. Evidence also shows that women will continue seeing their doctors for screening and preventive services even when allowed to purchase OCs without a prescription or doctor’s appointment. Women who receive more than one month’s supply of OCs at a time have higher contraceptive continuation rates than those who receive fewer pill packs.